Pathology

Question 1

What is myxomatous degeneration of arteries? What condition is it associated with?

Answer 1

Myxomatous Degen: cystic medial degen (fragmentation of elastic tissue) -> predisposes to aortic aneurysms

Associated with Marfan’s

Question 2

Myocardial Bx in acute rheumatic fever vs. viral myocarditis?

Answer 2

Rheumatic fever: preceded by GAS infection - shows mononuclear inflam infiltrate and scattered multinucleated giant cells –> which will then be replaced by fibrous tissue- any of the 3 layers of the heart

Viral: lymphocytic inflammatory infiltrate

Question 3

Histology Koilocyte

Answer 3

Immature Squamous Cell infected with HPV

dense irregularly staining cytoplasm

perivascular clearing = “halo” - pyknotic nucleus - dense, condensed Q1015

Question 4

Hepatitis B histology

Answer 4

“ground glass” eosinophilic granules within cytoplasm are HbSAg

Q367

Question 5

When would you see signs of ischemia in an MI under light microscopy?

Answer 5

No signs until after 4 hours of onset
0-4 minimal change
4-12h coagulation necrosis, edema, hemorrhage, wavy fibers
12-24h coagulation necrosis, contraction band necrosis
1-5 days coagulation necrosis + PMN
5-10 days macrophage phago dead cells
10-14 wks granulation tissue, neovas
2 wks-2 mos collagen deposition/scar

Question 6

Valvular vegetations in endocarditis are composed of what?

Answer 6

Fibrin and platelet deposition at a site of bacterial colonization.

Question 7

Pathology of someone with hypersensitivity to tobacco extract and intermittent claudication?

Answer 7

Segmental Thrombosing Vasculitis

Question 8

Pulmonary abscess are formed how?

Answer 8

Suppurative destruction of lung parenchyma 2/2 lysosomal content release by macrophages and neutrophils.

Question 9

Urticaria characterized by

Answer 9

dermal edema.

Question 10

What do metalloproteinases do?

Answer 10

Zn-containing enzymes that degrade extracellular matrix. Impt for tissue remodeling and tumor invasion thru basement membrane.

Question 11

What changes need to happen for tumor to met?

Answer 11

1. Detachment of tumor cell - loss of E-cadherin
2. Adhere to basement membrane - increased expression of laminin
3. invasion of basement membrane - metalloproteinases

Question 12

Histology of cell undergoing apoptosis?

Answer 12

Nuclear fragmentation. Intensely eosinophilic - acidophilic bodies.

Question 13

What is dystrophic calcification and what does it indicate?

Answer 13

Calcification 2/2 necrosis. Usually in heart valves or atheromatous plaques; anywhere there is necrosis Pts are normocalcemic (vs. metastatic calcification in kidney, lungs, Gi 2/2 hypercalcemia).

Question 14

Pentazocine is what type of drug?

Answer 14

Partial opioid agonist, weak antagonist - mu receptor.

Use: Analgesia with little abuse potential

May cause withdrawal in opioid dependent people.

Question 15

What enzyme is a reverse transcriptase? High activity would be found in what type of cell?

Answer 15

Telomerase is a RT. Has RNA template which it uses to add TTAGGG to 3’ end of DNA. High activity found in cancer cells.

Question 16

What signs of irreversible cell injury?

Answer 16

MItochondrial vacuolization
Nuclear pyknosis (condensation), 
karyorrhexis (fragment), 
karyolysis (lysis!)
Lysosomal rupture 

Reversible: mito swelling, nuclear chromatin clumping, disaggregation of nuclear granuoles

Question 17

Foreign Bodies elicit what response

Answer 17

Granulomatous

Question 18

Steps of Collagen Synthesis

Answer 18

1. signal sequence directs growing polypeptide chain into RER (pre-pro alpha chain)
2. signal sequence is cleaved (pro-alpha chains)
3. hydroxylation of proline and lysine residues (vit C)
4. glycosylation of lysine residues
5. assembly of pro-alpha chains into procollagen triple helix 6. secreted -> golgi -> extracellular
6. N and C- terminal propeptides (lots of disulfide bonds cleaved) cleaved –> tropocollagen
7. spontaneous assembly of tropocollagen into collagen fibrils
8. covalent crosslinks by lysyl oxidase.

Question 19

Proteins responsible for localized amyloidosis in: - cardiac- thyroid - pancreatic islet- cerebrum/cerebral blood vessels - pituitary gland And primary systemic amyloidosis?

Answer 19

cardiac: atrial naturietic peptide
thyroid: calcitonin

pancreatic islet: islet amyloid protein (amylin)

cerebrum/cerebral blood vessels: beta-amyloid protein- pituitary: prolactin systemic: Immunoglobulin light chain.

Question 20

Features of Anaplastic cells (undifferentiated)

Answer 20

Pleomorphism (Variation size, shape)
Loss of cell polarity, coalesce into sheets
Giant multinucleated cells
Numerous, abnl mitotic figures
Nuclei: - pleomorphic
high N:C ratio- coarsely clumped chromatin and large nucleoli

Question 21

Key Growth factors in angiogenesis?

Answer 21

VEGF FGF

Question 22

Lipoma vs. Liposarcoma

Answer 22

Liposarcoma: round clear cytoplasmic vacuoles scalloping the nucleus (cytoplasmic lipids that shift periodically), round cells with many mitoses

Lipoma: mature fat cells without pleomorphism

Key: messed up nucleus = malignant.

Question 23

Tissue Ischemia results in what electrolyte changes?

Answer 23

No ATP - Na/K ATP pump messed up. Less Na gradient flowing in - Na/Ca channel messed up.
Lactic acidosis - increased extra pH
decreased extracell HCO3

Decrease EXTRAcell Na, Ca, HCO3

Increased EXTRAcell K.

Note: Increased cytoplasmic Ca is hallmark of ischemic injury.